FOLFOX方案肝动脉灌注化疗治疗肝恶性肿瘤致剧烈腹痛的危险因素分析

肝癌电子杂志 ›› 2026, Vol. 13 ›› Issue (3): 59-65.

FOLFOX方案肝动脉灌注化疗治疗肝恶性肿瘤致剧烈腹痛的危险因素分析

岳子鹏, 张伟, 王梁, 谭永胜, 訾洋, 石宝琪^*

内蒙古自治区人民医院介入诊疗科,内蒙古呼和浩特 010020

收稿日期:2026-02-09 出版日期:2026-09-30 发布日期:2026-10-28
通讯作者: ^* 石宝琪,E-mail:shibaoqi1976@126.com
基金资助:
医路攀升-介入科研基金（iGandanF-1082025-YLPS004）

Analysis of risk factors for severe abdominal pain induced by FOLFOX-HAIC treatment in hepatic malignancies

Yue Zipeng, Zhang Wei, Wang Liang, Tang Yongsheng, Zi Yang, Shi Baoqi^*

Department of Imaging Medicine, Inner Mongolia People's Hospital, Hohhot 010020, Inner Mongolia, China

Received:2026-02-09 Online:2026-09-30 Published:2026-10-28
Contact: ^* Shi Baoqi, E-mail: shibaoqi1976@126.com

摘要/Abstract

摘要： 目的：分析FOLFOX（奥沙利铂、氟尿嘧啶、亚叶酸钙）方案肝动脉灌注化疗（HAIC）治疗肝恶性肿瘤患者时发生剧烈腹痛的危险因素,以优化治疗方案并提高治疗耐受性。
方法：回顾性分析2021年1月至2024年12月在内蒙古自治区人民医院介入诊疗科接受FOLFOX方案HAIC治疗的217例原发性及继发性肝恶性肿瘤患者资料。对在HAIC泵药期间及泵药结束后24 h内出现腹痛症状的33例患者进行分析,并根据视觉模拟评分法（VAS）评分分为剧烈腹痛组（VAS评分≥7分）和普通腹痛组（VAS评分<7分）。通过Logistic回归法单因素、多因素分析导致发生剧烈腹痛的因素。进一步对剧烈腹痛组VAS评分与置管动脉直径相关性进行Kendall分析。
结果：33例患者中剧烈腹痛患者（VAS 评分≥7分）16例,普通腹痛患者（VAS 评分<7分）17例。两组基线指标除奥沙利铂累积剂量、肝总动脉、肝固有动脉及置管动脉直径外均具有可比性（均P>0.05）。单因素分析显示年龄、肝总动脉直径、肝固有动脉直径、置管动脉直径及奥沙利铂累积剂量是造成患者剧烈腹痛的因素（均P<0.05）。多因素Logistic回归分析显示置管动脉直径是剧烈腹痛的独立危险因素（P<0.05）。剧烈腹痛组VAS评分与置管动脉直径呈负相关（r=-0.535,P<0.05）。
结论：置管动脉直径是FOLFOX方案HAIC治疗后剧烈腹痛发生的独立危险因素,较小的动脉直径可能导致局部缺血,进而引发剧烈腹痛。

关键词: 肝恶性肿瘤, 介入治疗, FOLFOX方案, 腹痛, 危险因素分析

Abstract: Objective:This study aims to analyze the risk factors for severe abdominal pain in patients with liver malignant tumors treated with FOLFOX regimen hepatic arterial infusion chemotherapy (HAIC) in order to optimize the treatment plan and improve treatment tolerance.
Methods:This study retrospectively analyzed the data of 217 patients with primary and secondary liver malignancy who received FOLFOX-HAIC treatment at the Department of Imaging Medicine, Inner Mongolia People's Hospital, from January 2021 to December 2024. A total of 33 patients who experienced abdominal pain during HAIC pump medication and within 24 hours after medication cessation were analyzed. These patients were categorized into a severe abdominal pain group and a mild abdominal pain group based on visual analog scale (VAS) scores. Univariate and multivariate Logistic regression analyses were conducted to identify factors contributing to severe abdominal pain. Additionally, a Kendall correlation analysis was performed to examine the relationship between VAS scores in the severe pain group and the diameter of the catheterized artery.
Results:Of these 33 patients, 16 experienced severe abdominal pain （VAS≥7), and 17 experienced mild-to-moderate abdominal pain (VAS < 7). Baseline characteristics were comparable between the two groups, with no statistically significant differences (all P>0.05), except for the total dose of oxaliplatin and the diameters of the common hepatic artery, proper hepatic artery, and catheterized artery. Univariate logistic analysis identified age, diameters of the common hepatic artery, proper hepatic artery, and catheterized artery, as well as the total dose of oxaliplatin, as factors associated with severe abdominal pain (all P<0.05). Multivariate logistic analysis revealed that the diameter of the catheterized artery was an independent risk factor for severe abdominal pain (P<0.05). Further analysis of the correlation between VAS scores and catheterized artery diameter in the severe abdominal pain group demonstrated a significant negative correlation (r= -0.535, P<0.05).
Conclusions:This study shows that the diameter of the catheterized artery is an independent risk factor for the occurrence of severe abdominal pain after FOLFOX-HAIC treatment. Smaller artery diameter may lead to local ischemia, thereby causing severe abdominal pain.

Key words: Liver malignancy, Interventional therapy, FOLFOX regimen, Abdominal pain, Analysis of risk factors

岳子鹏, 张伟, 王梁, 谭永胜, 訾洋, 石宝琪. FOLFOX方案肝动脉灌注化疗治疗肝恶性肿瘤致剧烈腹痛的危险因素分析[J]. 肝癌电子杂志, 2026, 13(3): 59-65.

Yue Zipeng, Zhang Wei, Wang Liang, Tang Yongsheng, Zi Yang, Shi Baoqi. Analysis of risk factors for severe abdominal pain induced by FOLFOX-HAIC treatment in hepatic malignancies[J]. Electronic Journal of Liver Tumor, 2026, 13(3): 59-65.

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